Psychosis

A psychosis is a major psychiatric disorder characterized by the inability
to tell what is real from what is not real. Hallucinations, delusions, and
thought disorders can accompany psychosis. People who are psychotic often
have a difficult time communicating with or relating to others. Sometimes
they become agitated and violent. Among the conditions that include
symptoms of psychosis are schizophrenia and manic depression (also known
as bipolar disorder).

Psychotic episodes may last for a brief period or for weeks and months at
a time. Psychosis can arise from emotional or organic causes. Organic
causes include brain tumors, drug interactions, or drug or alcohol abuse.
Since the 1950s, new medications have been developed to effectively
treat psychosis, allowing a person suffering from delusions or
hallucinations to regain a more accurate view of reality.

Forms of psychosis

Schizophrenia (skitz-o-FREN-ee-uh) is most frequently associated with
psychosis. It is a mental illness that is characterized by delusions,
hallucinations, thought disorders, disorganized speech and behavior, and
sometimes catatonic behavior (an abnormal condition in which a person
remains quiet and paralyzed). Emotions tend to flatten out (lose the
normal peaks and valleys of happiness and sadness) and it becomes
increasingly more difficult for the person to function normally in
society.

Whereas schizophrenia is a thought disorder, manic-depressive disorder is
a mood disorder. While the mood of a person suffering from schizophrenia
is flat, the mood of a person suffering from manic depression can swing
from great excitability to deep depression and feelings of hopelessness.
Many manic-depressive patients also experience delusions and
hallucinations.

Words to Know

Delusions:
Incorrect beliefs about reality that are clearly false.

Hallucinations:
Seeing, feeling, hearing, or smelling something that does not exist in
reality.

Manic depression:
Also called bipolar disorder, a mental illness characterized by severe
mood swings from depression to mania (great enthusiasm, energy, and
joy).

Schizophrenia:
A serious mental illness characterized by isolation from others and
thought and emotional disturbances.

Synapses:
Junctions between nerve cells in the brain where the exchange of
electrical or chemical information takes place.

Symptoms of psychosis

Hallucinations are a major symptom of psychosis and can be defined as
sense perceptions that are not based in reality. Auditory hallucinations
are the most common form. Patients hear voices that seem to be either
outside or inside their heads. The voices may be argumentative or
congratulatory. Patients who experience visual hallucinations may have an
organic problem, such as a brain lesion. Other types of hallucinations
involve the sense of smell and touch.

Delusions, incorrect beliefs about reality, are another symptom of
psychosis. There are various types of delusions. Delusional patients may
believe they are extremely important and powerful, or that they have a
special relationship with a political leader, a Hollywood star, or God.
Other delusional patients may feel they are being persecuted or mistreated
by someone when no such persecution or mistreatment is taking place.
Further delusions include unwarranted jealousy or the strongly held belief
that one suffers from a disease or physical defect.

Medications for treatment

Antipsychotic drugs are prescription medications used to treat psychosis.
The vast majority of antipsychotics work by blocking the absorption of
dopamine, a chemical that occurs naturally in the brain. Dopamine is
responsible for transmitting messages across the synapses, or junctions
between nerve cells in the brain. Too much dopamine in a person's
brain speeds up nerve impulses to the point of causing hallucinations,
delusions, and thought disorders.

Antipsychotic medications were not used in the United States before 1956.
Once these drugs, such as Thorazine™, were introduced, they gained
widespread acceptance for the treatment of schizophrenia. The use of these
drugs allowed the release of many people who had been confined to mental
institutions.

Despite their benefits, antipsychotic medicines have a number of strong
side effects. Among the most severe are muscle rigidity, muscle spasms,
twitching, and constant movement. Perhaps the most serious side effect is
neuroleptic malignant syndrome (NMS). This condition occurs when a patient
taking an antipsychotic drug is ill or takes a combination of drugs.
People suffering from NMS cannot move or talk. They also have unstable
blood pressure and heart rates. Often, NMS is fatal.

Recently, a new generation of antipsychotic drugs has been developed as a
result of discoveries about how the brain works. These new drugs have
fewer side effects. Some do not completely block dopamine receptors;
others are selective, blocking only one type of dopamine receptor.